Healthcare Provider Details

I. General information

NPI: 1952056715
Provider Name (Legal Business Name): NGOZI M ONWUMELU CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2022
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 WISCONSIN AVE BLDG 193
BETHESDA MD
20889-5477
US

IV. Provider business mailing address

3806 ANGELTON CT
BURTONSVILLE MD
20866-2060
US

V. Phone/Fax

Practice location:
  • Phone: 301-319-2929
  • Fax:
Mailing address:
  • Phone: 301-338-1032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberR211356
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberR211356
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberR211356
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: